Medical Family Therapy in Oncology

  • Talia Zaider
  • Peter Steinglass
Part of the Focused Issues in Family Therapy book series (FIFT)


Cancer diagnoses encompass a broad and varied group of diseases that share the feature of abnormal and uncontrolled cell growth. In the United States alone, an estimated 1.6 million new cases of cancer were diagnosed last year (American Cancer Society, 2016). Once considered a death sentence, many cancers are now treated as chronic illnesses that require long-term management (McCorkle et al., 2011). This shift from acute to chronic care for patients with cancer represents a culmination of continually evolving medical advances that have succeeded in prolonging survival and expanding the range of available treatment options.


Glossary of Important Terms for Care in Oncology


A surgical procedure to remove a segment of a tumor for the purpose of determining a precise diagnosis.


A cancer that begins in the skin or tissues that line the inside or cover the outside of internal organs.

Curative treatment

Treatment intended (and expected) to destroy the cancer.

Disease-free survival (DFS)

A measure of time following treatment during which no signs of cancer are discovered.


A cancer that is confined to the area where it began; it has not spread to other parts of a patient’s body.


A tumor is malignant when there is evidence of disease, as differentiated from a tumor said to be “benign” or noncancerous.


The spread of cancer to organs beyond where it began (which is referred to as the “primary” or “original” site).

Palliative treatment

Treatment intended to relieve symptoms and pain associated with the cancer.


The disappearance of cancer signs and symptoms (but not necessarily the disease, itself); this can be temporary or permanent in duration.

Tumor markers

Substances that can be measured in the blood, urine, or body tissues to indicate the presence of cancer.


  1. American Cancer Society. (2016). Cancer facts and cures 2016. Retrieved from
  2. Badr, H., & Krebs, P. (2013). A systematic review and meta analysis of psychosocial interventions for couples coping with cancer. Psycho-Oncology, 22, 1688–1704. CrossRefPubMedGoogle Scholar
  3. Bakitas, M., Lyons, K. D., Hegel, M. T., Balan, S., Brokaw, F. C., Seville, J., … Byock, I. R. (2009). Effects of a palliative care intervention on clinical outcomes in patients with advanced cancer: The project ENABLE II randomized controlled trial. Journal of the American Medical Association, 302, 741–749. CrossRefPubMedPubMedCentralGoogle Scholar
  4. Bauman, J. R., & Temel, J. S. (2014). The integration of early palliative care with oncology care: The time has come for a new tradition. Journal of the National Comprehensive Cancer Network, 12, 1763–1771. CrossRefPubMedPubMedCentralGoogle Scholar
  5. *Breitbart, W. S., Breitbart, W., & Poppito, S. R. (2014). Individual meaning-centered psychotherapy for patients with advanced cancer: A treatment manual. Oxford, England: Oxford University Press.Google Scholar
  6. Brown, R. T., Madan Swain, A., & Lambert, R. (2003). Posttraumatic stress symptoms in adolescent survivors of childhood cancer and their mothers. Journal of Traumatic Stress, 16, 309–318. CrossRefPubMedGoogle Scholar
  7. Cloutier, P. F., Manion, I. G., Walker, J. G., & Johnson, S. M. (2002). Emotionally focused interventions for couples with chronically ill children: A 2 year follow up. Journal of Marital and Family Therapy, 28, 391–398. CrossRefPubMedGoogle Scholar
  8. Denton, W. H., Wittenborn, A. K., & Golden, R. N. (2012). Augmenting antidepressant medication treatment of depressed women with emotionally focused therapy for couples: A randomized pilot study. Journal of Marital and Family Therapy, 38, 23–38. CrossRefPubMedPubMedCentralGoogle Scholar
  9. Dockham, B., Schafenacker, A., Yoon, H., Ronis, D. L., Kershaw, T., Titler, M., & Northouse, L. (2016). Implementation of a psychoeducational program for cancer survivors and family caregivers at a cancer support community affiliate: A pilot effectiveness study. Cancer Nursing, 39, 169–180. CrossRefPubMedGoogle Scholar
  10. Dessaulles, A., Johnson, S. M., & Denton, W. H. (2003). Emotion-focused therapy for couples in the treatment of depression: A pilot study. American Journal of Family Therapy, 31, 345–353. CrossRefGoogle Scholar
  11. Engel, G. L. (1977). The need for a new medical model: A challenge for biomedicine. Science, 196, 129–136. CrossRefPubMedGoogle Scholar
  12. Engel, G. L. (1980). The clinical application of the biopsychosocial model. American Journal of Psychiatry, 137, 535–544. CrossRefPubMedGoogle Scholar
  13. Epstein, R. M., Duberstein, P. R., Fenton, J. J., Fiscella, K., Hoerger, M., Tancredi, D. J., … Franks, P. (2017). Effect of a patient-centered communication intervention on oncologist-patient communication, quality of life, and health care utilization in advanced cancer: The VOICE randomized clinical trial. JAMA Oncology, 3, 92–100. PubMedPubMedCentralGoogle Scholar
  14. Gueguen, J. A., Bylund, C. L., Brown, R. F., Levin, T. T., & Kissane, D. W. (2009). Conducting family meetings in palliative care: Themes, techniques, and preliminary evaluation of a communication skills module. Palliative & Supportive Care, 7, 171–179. CrossRefGoogle Scholar
  15. Hodgson, J. L., McCammon, S. L., & Anderson, R. J. (2011). A conceptual and empirical basis for including medical family therapy services in cancer care settings. American Journal of Family Therapy, 39, 348–359. CrossRefGoogle Scholar
  16. Hodgson, J., Lamson, A., Mendenhall, T., & Tyndall, L. (2014). Introduction to Medical Family Therapy: Advanced Applications. In J. Hodgson, A. Lamson, T. Mendenhall., and D. Crane (Eds.). Medical family therapy: Advanced applications (pp. 1–9). New York, NY: Springer.Google Scholar
  17. *Holland, J. C. (2000). Improving the human side of cancer care: Psycho-oncology’s contribution. Cancer Journal, 7, 458–471. Retrieved from
  18. *Holland, J. C., Breitbart, W. S., Jacobsen, P. B., Butow, P. N., Loscalzo, M. J., & McCorkle, R. (Eds.). (2015). Psycho-oncology (3rd ed.). Oxford, England: Oxford University Press.Google Scholar
  19. Hudson, P., Thomas, T., Quinn, K., & Aranda, S. (2009). Family meetings in palliative care: Are they effective? Palliative Medicine, 23, 150–157. CrossRefPubMedGoogle Scholar
  20. Institute of Medicine Committee on the Future Health Care Workforce for Older Adults. (2008). Retooling for an aging America: Building the health care workforce. Washington, DC: National Academies Press.Google Scholar
  21. Johnson, S. (2004). The practice of emotionally focused couple therapy: Creating connection. New York, NY: Brunner-Routledge.Google Scholar
  22. Kazak, A. E., Boeving, C. A., Alderfer, M. A., Hwang, W.-T., & Reilly, A. (2005). Posttraumatic stress symptoms during treatment in parents of children with cancer. Journal of Clinical Oncology, 23, 7405–7410. CrossRefPubMedGoogle Scholar
  23. *Kent, E. E., Rowland, J. H., Northouse, L., Litzelman, K., Chou, W. Y. S., Shelburne, N., … Huss, K. (2016). Caring for caregivers and patients: research and clinical priorities for informal cancer caregiving. Cancer, 122, 1987–1995.
  24. Kim, Y., Kashy, D. A., Wellisch, D. K., Spillers, R. L., Kaw, C. K., & Smith, T. G. (2008). Quality of life of couples dealing with cancer: Dyadic and individual adjustment among breast and prostate cancer survivors and their spousal caregivers. Annals of Behavioral Medicine, 35, 230–238. CrossRefPubMedGoogle Scholar
  25. Kim, Y., Shaffer, K. M., Carver, C. S., & Cannady, R. S. (2015). Quality of life of family caregivers 8 years after a relative's cancer diagnosis: Follow-up of the National Quality of Life Survey for Caregivers. Psychooncology, 25, 266–274. CrossRefPubMedGoogle Scholar
  26. Kissane, D. W. (2013). Marriage is as protective as chemotherapy in cancer care. American Society of Clinical Oncology, 31, 3852–3853. CrossRefGoogle Scholar
  27. *Kissane, D. W., & Bloch, S. (2002). Family focused grief therapy. Philadelphia, PA: Open University Press.Google Scholar
  28. Kissane, D. W., Bloch, S., Onghena, P., & McKenzie, D. P. (1996). The Melbourne Family Grief Study II: Psychosocial morbidity and grief in bereaved families. American Journal of Psychiatry, 153, 659–666. CrossRefPubMedGoogle Scholar
  29. Kissane, D. W., Bylund, C. L., Banerjee, S. C., Bialer, P. A., Levin, T. T., Maloney, E. K., & D'Agostino, T. A. (2012). Communication skills training for oncology professionals. Journal of Clinical Oncology, 30, 1242–1247. CrossRefPubMedPubMedCentralGoogle Scholar
  30. *Kissane, D. W., & Hempton, C. (2017). Conducting a family meeting. In D. Kissane, B. Bultz, P. Butow, C. Bylund, S. Noble, and S. Wilkinson (Eds.), Oxford textbook of communication in oncology and palliative care (2nd ed., pp. 110–119). Oxford, England: Oxford University Press.Google Scholar
  31. *Kissane, D. W., & Parnes, F. (2014). Bereavement care for families. New York, NY: Routledge.Google Scholar
  32. Kissane, D., Zaider, T., Li, Y., Hichenberg, S., Schuler, T., Lederberg, M., … Del Gaudio, F. (2016). Randomized controlled trial of family therapy in advanced cancer continued into bereavement. Journal of Clinical Oncology, 24, 1921–1930. CrossRefGoogle Scholar
  33. Makinen, J. A., & Johnson, S. M. (2006). Resolving attachment injuries in couples using emotionally focused therapy: Steps toward forgiveness and reconciliation. Journal of Consulting and Clinical Psychology, 74, 1055–1064. CrossRefPubMedGoogle Scholar
  34. Manne, S. L., Kissane, D. W., Nelson, C. J., Mulhall, J. P., Winkel, G., & Zaider, T. (2011). Intimacy enhancing psychological intervention for men diagnosed with prostate cancer and their partners: A pilot study. Journal of Sexual Medicine, 8, 1197–1209. CrossRefPubMedPubMedCentralGoogle Scholar
  35. McCorkle, R., Ercolano, E., Lazenby, M., Schulman Green, D., Schilling, L. S., Lorig, K., & Wagner, E. H. (2011). Self management: Enabling and empowering patients living with cancer as a chronic illness. CA: A Cancer Journal for Clinicians, 61, 50–62.
  36. McLean, L. M., Walton, T., Rodin, G., Esplen, M. J., & Jones, J. M. (2013). A couple based intervention for patients and caregivers facing end stage cancer: Outcomes of a randomized controlled trial. Psycho-Oncology, 22, 28–38. CrossRefPubMedGoogle Scholar
  37. McLeod, D. L., Tapp, D. M., Moules, N. J., & Campbell, M. E. (2010). Knowing the family: Interpretations of family nursing in oncology and palliative care. European Journal of Oncology Nursing, 14, 93–100. CrossRefPubMedGoogle Scholar
  38. Naaman, S. C. (2008). Evaluation of the clinical efficacy of emotionally focused couples therapy on psychological adjustment and natural killer cell cytotoxicity in early breast cancer. Doctoral dissertation, University of Ottawa (Canada). Retrieved from
  39. National Comprehensive Care Network. (2017). NCCN guidelines. Retrieved from (2017)
  40. *Northouse, L. L. (2012). Helping patients and their family caregivers cope with cancer. Oncology Nursing Forum, 39, 500–506.
  41. Ostroff, J., Ross, S., & Steinglass, P. (2000). Psychosocial adaptation following treatment: A family systems perspective on childhood cancer survivorship. In L. Baider, C. Cooper, and A. De-Nour (Eds.), Cancer and the family (2nd ed., pp. 155–174). West Sussex, England: John Wiley & Sons.Google Scholar
  42. *Ostroff, J., Ross, S., Steinglass, P., Ronis-Tobin, V., & Singh, B. (2004). Interest in and barriers to participation in multiple family groups among head and neck cancer survivors and their primary family caregivers. Family Process, 43, 195–208.
  43. Pirl, W. F., Fann, J. R., Greer, J. A., Braun, I., Deshields, T., Fulcher, C., … Lazenby, M. (2014). Recommendations for the implementation of distress screening programs in cancer centers: Report from the American Psychosocial Oncology Society (APOS), Association of Oncology Social Work (AOSW), and Oncology Nursing Society (ONS) joint task force. Cancer, 120, 2946–2954. CrossRefPubMedGoogle Scholar
  44. *Rauch, P., & Muriel, A. (2005). Raising an emotionally healthy child when a parent is sick. New York, NY: McGraw Hill.Google Scholar
  45. *Reiss, D., Steinglass, P., & Howe, G. (1993). The family’s organization around the illness. How do families cope with chronic illness. In R. Cole and D. Reiss (Eds.), How do families cope with illness? (pp. 173–213). Hillside, NJ: Laurence Erlbaum Associates.Google Scholar
  46. Rolland, J. S. (1994). Families, illness, and disability: An integrative treatment model. New York, NY: Basic Books.Google Scholar
  47. *Rolland, J. S. (2005). Cancer and the family: An integrative model. Cancer, 104, 2584–2595.
  48. Schaefer, K. G., & Block, S. D. (2009). Physician communication with families in the ICU: Evidence-based strategies for improvement. Current Opinion in Critical Care, 15, 569–577. CrossRefPubMedGoogle Scholar
  49. Schenker, Y., Park, S. Y., Maciasz, R., & Arnold, R. M. (2014). Do patients with advanced cancer and unmet palliative care needs have an interest in receiving palliative care services? Journal of Palliative Medicine, 17, 667–672. CrossRefPubMedPubMedCentralGoogle Scholar
  50. Schuler, T. A., Zaider, T. I., Li, Y., Hichenberg, S., Masterson, M., & Kissane, D. W. (2014). Typology of perceived family functioning in an American sample of patients with advanced cancer. Journal of Pain and Symptom Management, 48, 281–288. CrossRefPubMedPubMedCentralGoogle Scholar
  51. Schuler, T. A., Zaider, T. I., Li, Y., Masterson, M., McDonnell, G. A., Hichenberg, S., … Kissane, D. W. (2017). Perceived family functioning predicts baseline psychosocial characteristics in US participants of a family focused grief therapy trial. Journal of Pain and Symptom Management, 54, 126–131. CrossRefPubMedGoogle Scholar
  52. Scott, J. L., Halford, W. K., & Ward, B. G. (2004). United we stand? The effects of a couple-coping intervention on adjustment to early stage breast or gynecological cancer. Journal of Consulting and Clinical Psychology, 72, 1122–1135. CrossRefPubMedGoogle Scholar
  53. Sklenarova, H., Krumpelmann, A., Haun, M. W., Friederich, H. C., Huber, J., Thomas, M., … Hartmann, M. (2015). When do we need to care about the caregiver? Supportive care needs, anxiety, and depression among informal caregivers of patients with cancer and cancer survivors. Cancer, 121, 1513–1519. CrossRefPubMedGoogle Scholar
  54. Smith, T. J., Temin, S., Alesi, E. R., Abernethy, A. P., Balboni, T. A., Basch, E. M., … Paice, J. A. (2012). American Society of Clinical Oncology provisional clinical opinion: The integration of palliative care into standard oncology care. Journal of Clinical Oncology, 30, 880–887.
  55. *Steinglass, P. (1998). Multiple family discussion groups for patients with chronic medical illness. Families, Systems, & Health, 16, 55–70.
  56. Traeger, L., Park, E. R., Sporn, N., Repper-DeLisi, J., Convery, M. S., Jacobo, M., & Pirl, W. F. (2013). Development and evaluation of targeted psychological skills training for oncology nurses in managing stressful patient and family encounters. Oncology Nursing Forum, 40, E327–E336. CrossRefPubMedGoogle Scholar
  57. Walker, J. G., Johnson, S., Manion, I., & Cloutier, P. (1996). Emotionally focused marital intervention for couples with chronically ill children. Journal of Consulting and Clinical Psychology, 64, 1029–1036. CrossRefPubMedGoogle Scholar
  58. Walker, J. G., Manion, I. G., Cloutier, P. F., & Johnson, S. M. (1992). Measuring marital distress in couples with chronically ill children: The Dyadic Adjustment Scale. Journal of Pediatric Psychology, 17, 345–357. CrossRefPubMedGoogle Scholar
  59. *Watson, M., & Kissane, D. W. (Eds.). (2011). Handbook of psychotherapy in cancer care. Hoboken, NJ: Wiley-Blackwell.Google Scholar
  60. Wiebe, S. A., & Johnson, S. M. (2016). A review of the research in emotionally focused therapy for couples. Family Process, 55, 390–407. CrossRefPubMedGoogle Scholar
  61. Wright, L. M., Watson, W. L., & Bell, J. M. (1996). Beliefs: The heart of healing in families and illness. New York, NY: Basic Books.Google Scholar
  62. Zaider, T. I., Banerjee, S. C., Manna, R., Coyle, N., Pehrson, C., Hammonds, S., … Bylund, C. L. (2016). Responding to challenging interactions with families: A training module for inpatient oncology nurses. Families, Systems, & Health, 34, 204–212. CrossRefGoogle Scholar
  63. *Zaider, T., & Kissane, D. (2009). The assessment and management of family distress during palliative care. Current Opinion in Supportive and Palliative Care, 3, 67–71.
  64. Zaider, T. I., & Kissane, D. W. (2011). Couples therapy in advanced cancer: Using intimacy and meaning to reduce existential distress. In M. Watson and D. Kissane (Eds.), Handbook of psychotherapy in cancer care (pp. 159–173). Hoboken, NJ: Wiley-Blackwell.Google Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Psychiatry and Behavioral ScienceMemorial Sloan Kettering Cancer CenterNew YorkUSA
  2. 2.Ackerman Institute for the FamilyNew YorkUSA

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